Idaho
The Idaho Administrative Rules Special Edition Bulletin, Volume 21-12SE, December 22, 2021, has been published. The following rules have been adopted by the respective agency and are now pending review by the 2022 Idaho State Legislature for final approval.
- Office of the Attorney General – See "Rules of Administrative Procedure for Consideration of Cooperative Agreements Filed by Health Care Providers" on pages 527-41.
- Department of Health and Welfare – Medicaid Basic Plan Benefits
- See "664. PRESCRIPTION DRUGS: PROVIDER QUALIFICATIONS AND DUTIES" on pages 1778-9;
- "665. PRESCRIPTION DRUGS: PROVIDER REIMBURSEMENT" on pages 1779-83 and
- "666. PRESCRIPTION DRUGS: QUALITY ASSURANCE" on page 1783.
- The Division of Occupational and Profession Licenses pending fee rule – See pages 3350-1 for the Idaho State Board of Pharmacy fees.
Also in Idaho, the Board of Pharmacy published the "Idaho State Newsletter" – December 2021. Below is an outline of its contents. Note the Idaho PDMP (Prescription Drug Monitoring Program) requirement effective November 1, 2021.
- Remaining CPE (Council for Pharmacist Education) credits for 2021
- "Culture of Safety" – Medication events and process improvements in 2021
- Requirement for "Date Sold" in Idaho PDMP
- Technician registration assistance
- 2022 Board Meeting Schedule
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Indiana
The Department of Health issued a new statewide naloxone standing order.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Department of Human Services, Iowa Medicaid Enterprise (IME) published INFORMATIONAL LETTER No. 2301-MC-FFS regarding a variety of listening sessions for providers scheduled for January and February. IME’s goal for these sessions is to hear from providers with experience related to assorted topics and who have ideas for ways to improve processes and policies associated with these topics.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
At the Regulation Revision Committee (RRC) meeting on January 5th, members revised and approved several proposed legislative bill drafts of interest to chain pharmacies, including (1) amending the prescription monitoring program law to provide limited access to audit trail information to designated representatives of Louisiana Medicaid; (2) require Pharmacy Benefit Managers to obtain a permit from the Board of Pharmacy; (3) revising the definition of collaborative practice and authorizing pharmacists to provide certain patient care services in accordance with statewide protocols developed by the Board's Public Health and Pharmacy Protocol Advisory Committee and approved by the Board of Pharmacy; and (4) changing the definition of collaborative practice and adding a definition of a collaborative practice agreement authorizing pharmacists to engage in collaborative practice in accordance with rules promulgated by the Board of Pharmacy. The RRC also approved a draft CLIA (Clinical Laboratory Improvement Amendments) Waived Testing Policy statement confirming pharmacist's authority to perform these tests under federal law. The full Board of Pharmacy will be considering all these issues at their February 16th meeting.
Also in Louisiana, the Department of Health (LDH) issued a new Naloxone standing order. They also issued Louisiana Medicaid Pharmacy Point of Sale (POS) Diagnosis Code Requirement and Bypass Diagnosis Codes – Effective January 1, 2022; Louisiana Medicaid Pharmacy Point of Sale Clinical Authorization and Criteria Updates – Effective January 1, 2022; and Louisiana Medicaid Pharmacy Point of Sale Quantity Limits – Effective January 1, 2022
Finally in Louisiana, in advance of the December 28, 2021, Board of Pharmacy's Public Hearing, NACDS submitted comments in support of proposed rules that make permanent certain authorities for pharmacy technicians and interns authorized under the PREP (pre-exposure prophylaxis) Act. Specifically, the proposed rules would codify authority for pharmacy technicians and interns to administer vaccines, in addition to making other changes to the existing rules that simplify existing administrative requirements for vaccines provided by pharmacy providers. We anticipate that the final rule will be published on March 20, 2022, Louisiana Register, and become effective immediately.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
This week, Governor Hogan announced a 30-day State of Emergency in response to rising COVID-19 metrics in Maryland. The announcement includes Authorization of Booster Shots for 12- to 15-Year-Olds. Gov. Hogan’s press release is also available here.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
The Board of Pharmacy is seeking comments by January 14, 2022, on proposed rules removing geographic restrictions on remote data entry sites and allowing pharmacy technicians and intern pharmacists to perform remote data entry from a site located in another U.S. state or territory.
Also in Missouri, the National Association of Insurance Commissioners (NAIC) selected the Missouri Department of Commerce and Insurance Director Chlora Lindley-Myers as President-Elect for 2022.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Montana
The Dept. of Public Health and Human Services issued a Notice of Public Hearing on proposed amendments to ARM 37.85.105, updating effective dates of Medicaid fee schedules; see the relevant section related to outpatient drugs located on pages 1888-9. The public hearing will be held on January 13 and comments are due January 22.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nebraska
Gov. John Peter "Pete" Ricketts (R) signed Executive Order 21-18, facilitating hospital planning, and ensuring additional healthcare workforce capacity, on December 20, 2021. This extends the current Executive Order 21-15, allowing "pharmacists to have any number of pharmacist interns and pharmacy technicians under their supervision insofar as they determine it necessary within their professional discretion when administering vaccinations", until March 31, 2022.
Also in Nebraska, the 471-000-540 Nebraska Medicaid Practitioner Fee Schedule for Injectables was updated effective January 1.
Also in Nebraska, the Dept. of Health and Human Services issued a Health Alert Network Update: Omicron Predominant in Nebraska and Therapeutics Updates that includes an update on the Omicron variant of SARS-CoV-2 in Nebraska, NIH's criteria for identifying and prioritizing those expected to benefit the most from receiving the limited supply of COVID-19 therapeutics currently available and the NIH's treatment algorithm.
Also in Nebraska, the Board of Pharmacy will meet on January 10 and have posted the meeting agenda. Also, the November 8, 2021, meeting minutes are available.
Finally in Nebraska, the Dept. of Health and Human Services has posted the DUR (Drug Utilization Review) Board January 11, 2022, meeting agenda and DUR Policy Statements (as of July 2021).
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
On New Year's Eve NYS Governor Kathy Hochul (D) signed into law two pieces of legislation supported by NACDS. The first S3556 strengthens state anti-mandatory mail order (ammo) law. Legislators, concerned that the AMMO law was not operating as intended, passed S3566 to ensure that patients can get their prescriptions at their local pharmacy rather than be directed to mail order by their PBM. In addition, Governor Hochul signed into law S.3762 which provides for licensure and registration of pharmacy benefit managers. The bill also sets forth duties and obligations that PBMs must follow when performing services and allows the department of financial services to enforce the law and receive complaints from consumers, pharmacies, and healthcare providers. Unfortunately, Governor Hochul did veto S6603 which would have provided Medicaid pharmacy payment parity citing the fiscal note as her reasoning.
Also in New York: The State Education Department published its Notice of Adoption of their regulation related to Licensure Examination, Licensure by Endorsement, and Continuing Education Requirements in the Profession of Pharmacy The regulation is effective January 1, 2022 and eliminates the Part III exam requirement. Also commencing with registration periods beginning on or after January 1, 2023, a new requirement for a licensee to complete as part of the 45 hours of formal continuing education at least three hours of formal continuing education acceptable to the department in compounding, among other changes.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
Here are the links to the latest North Carolina information on COVID vaccinations including the latest statewide standing order issued by Dr. Betsey Tilson on December 22, 2021. COVID-19 Vaccine Provider Guidance Updated December 22, 2021 and Link to Summary Update.
Dr. Tilson has also issued four updated statewide standing orders regarding the administration of the COVID-19 vaccine. These changes were in light of the CDC recommending the administration of Pfizer booster doses for 12–15-year-old.
- Statewide Standing Order for FDA Approved Pfizer/COMIRNATY COVID-19 Vaccine Administration in Patients Ages 5-11 Years (Jan. 6, 2022)
- Statewide Standing Order for FDA Approved Pfizer/COMIRNATY COVID-19 Vaccine Administration in Patients Ages 12 Years and Older (Jan. 6, 2022)
- Statewide Standing Order for FDA Authorized Moderna COVID-19 Vaccine Administration (Jan. 6, 2022)
- Statewide Standing Order for FDA Authorized Johnson and Johnson (Janssen) COVID-19 Vaccine Administration (Jan. 6, 2022)
Also in North Carolina, the Board of Pharmacy published proposed administrative rules concerning pharmacy interns. These rules can be found beginning on Page 1049 (PDF Page 57) of the North Carolina Register at this link. The Board will hold a public hearing on these rules on February 8, 2022. The public hearing will be held remotely. The public can participate on Teams at https://tinyurl.com/jsuk4bjk or may call 336-604-5350, conference ID 903 191 899#. Written comments will be accepted by the Board until February 14, 2022, and should be submitted to Jay Campbell, 6015 Farrington Road, Suite 201, Chapel Hill, NC 27517; fax (919) 246-1056; email ncboprulemaking@ncbop.org.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
North Dakota
The Medicaid Provider e-Newsletter — December 2021 includes articles with information related to pharmacists being able to bill for smoking cessation and continuous glucose monitoring services. Also, the Medicaid Provider Call Center will be unavailable from 12:15 to 2:45 p.m. Central Time on many Fridays in 2022 for staff training; see schedule in the newsletter.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
The Department of Health has published updated Guidance for Ohio Vaccine Providers for Administering Booster Doses.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Board of Pharmacy adopted the following permanent rules.
| Permanent Rule | Effective Date |
| Division 007/041/045/065 – related to USP, Labeling, Repackaging | December 16, 2021 |
| Division 010 – related to Board Administration & Policies | December 16, 2021 |
| Division 019/021 – related to Pain Management CE | January 1, 2022 |
| Division 019/139 – related to Remote Dispensing Site Pharmacy/Telepharmacy | January 1, 2022 |
| Division 041 – related to Telework | December 16, 2021 |
| Division 041 – related to TCVP (Technician Checking Validation Program) | October 1, 2022 |
| Division 041/080 – related to Pseudoephedrine/Ephedrine | January 1, 2022 |
| Division 043 – related to SPDO/DPDO/CHC | January 1, 2022 |
| Division 043 – related to SPDO (Supervising Physician Dispensing Outlet) | March 31, 2022 |
| Division 060/110 – related to PDMP Fee Increase | January 1, 2022 |
Also in Oregon, as a reminder, effective January 1, 2022, drugs containing pseudoephedrine and ephedrine may be purchase without a prescription. See item above regarding the permanent rule related to pseudoephedrine/ephedrine. For information about the use of the National Precursor Log Exchange (NPLEx) system, please refer to the Board of Pharmacy's November 2021 newsletter.
Also in Oregon, the Board of Pharmacy issued a notice requesting fiscal impact estimates from stakeholders for temporary and permanent pharmacy closures. Note: any information provided to the Board becomes a public record.
Finally in Oregon, the Board of Pharmacy's CE Rules Advisory Committee will meet on January 18. Details to participate in the meeting via phone conference are available in the agenda.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
The Office of Medical Assistance Programs (OMAP) has announced by bulletin that they will now reimburse pharmacies a $10 administration fee for any vaccine provided to adult Medicaid patients consistent with the Pharmacy Practice Act, retroactive to Nov. 1, 2021, in both FFS and MC. Historically OMAP has only paid for ingredient costs. Billing codes are in the bulletin. Pharmacies cannot bill for vaccines covered under the VFC program.
Also in Pennsylvania: The Pennsylvania Prescription Drug Monitoring Program (PDMP) will be transitioning PDMP system vendors. This change will bring new enhancements to the PDMP that are based on feedback from PDMP users, including a single platform for pharmacists to search patients, and upload and edit data. Starting on January 10, 2022, PDMP users will need to transfer their accounts to create new login credentials and establish their SFTP credentials (if applicable) within the LogiCoy PDMP platform. Pharmacies using a third party for data submission must ensure their vendor also transfers their accounts. Transitioning accounts takes an average user less than two minutes, as registration has been streamlined to pre-populate information based on the user's license information. The transfer account period begins on January 10. During this time all PDMP users must, by February 14:
- Click "Transfer Account or Register"
- Follow the prompts and enter their information
- Ensure the information is correct and submit
Pharmacists (or their data submission vendor) will be able to test their data submission during this time. Please note, before February 14, PDMP users will continue to use PMP Aware to search patients and PMP Clearinghouse to upload data. On February 14, PDMP users will begin using the LogiCoy PDMP to search patients and upload data. Users who search patients through their organization's pharmacy management system will not need to change how they search patients and will not experience any changes to their pharmacy management system's connection to the PDMP. For more information about the PDMP, please visit: www.doh.pa.gov/pdmp. For assistance with account transfer, please contact LogiCoy technical support at 844-939-0999 or email papdmp@logicoy.com.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Texas
The Health and Human Services Commission (HHSC) includes COVID-19 at-home test kits as a Medicaid, Children's Health Insurance Program (CHIP), Healthy Texas Women (HTW), Kidney Health Care (KHC), and Children with Special Health Care Needs (CSHCN) pharmacy benefit effective January 3, 2022, for fee-for-service (FFS), and no later than January 17, 2022, for managed care. An adjudicated pharmacy claim is required for reimbursement of a COVID-19 at-home test. Clients may obtain COVID-19 at-home test kits from a Medicaid-enrolled retail pharmacy with or without a prescription from a prescribing provider.
Also in Texas, Gov. Greg Abbott (R) made several appointments to the Board of Pharmacy: Ian Shaw, a Dallas attorney will serve as a new public member, and pharmacists Suzette Tijerina and Jenny Yoakum were reappointed to serve a six-year term.
Also in Texas, the Health and Human Services Commission's Department of State Health Services is hosting weekly provider webinars on Tuesdays to share the latest COVID-19 vaccine information on ordering, administration, and reporting guidelines.
- Tuesday, January 11, Noon – 1:30 p.m. CT. Register here.
- Tuesday, January 18, Noon – 1:30 p.m. CT. Register here.
- Tuesday, January 25, Noon – 1:30 p.m. CT. Register here.
Finally in Texas, the Board of Pharmacy published two proposed rules in the Texas Register on 12/24/2021: (1) conforms to federal standards by extending the time period for pharmacists to dispense prescription drug orders for Schedule II controlled substances issued by an out-of-state practitioner to the end of the 30th day after the date the prescription is issued; and (2) determines the validity of prescriptions issued as a result of teledentistry dental services or telemedicine dental services. Comments are due to the TSBP by January 24, 2022.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
The Board of Pharmacy has published final emergency regulations authorizing pharmacists to initiate treatment with certain drugs, devices, controlled paraphernalia, and other OTC supplies and equipment for adult patients became effective December 22, 2021. Pharmacists may now utilize the new statewide protocols to initiate treatment for vaccines, TB, HIV PeP and PrEP, and over-the counter medications when they decrease a patient’s out-of-pocket expenses. The regulations are a result of legislation that members, allies and NACDS worked on in the 2021 legislative session.
Also in Virginia: The Department of Health has published a Revised COVID-19 Vaccine Standing Order has been updated and posted here. Also refer to the revised Summary of Legal Authorities for Pharmacists to Administer COVID-19 Vaccine. The updates to the Standing Order include:
Allowing any COVID-19 vaccine booster to be administered at an interval of 5 months, rather than 6 months, after completion of the Pfizer-BioNTech primary series (any COVID-19 vaccine booster remains recommended 6 months after a Moderna vaccine primary series and 2 months after Johnson & Johnson vaccine)
- Children 12-17 years old are recommended to receive a Pfizer booster vaccine 5 months following their primary series
- Children 5-11 years old who are immunocompromised are recommended to receive a 3rd Pfizer dose as part of their primary series 28 days after 2nd dose
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Alabama
Changes described in the ALERT dated November 5, 2021, regarding the replacement of Claim Adjustment Reason Code (CARC) Code 45 with CARC Code (96) will not be implemented. Gainwell verified CARC Code 45 still conforms to the Payment & Remittance Uniform Use of CARCs and RARCs (835) Rule. As a result, Alabama Medicaid will continue using CARC Code 45 to indicate pricing adjustments to payments due to fee schedules/allowed amounts.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
The Department of Health Care Services continues to post and publish information to prepare pharmacy providers for the implementation of Medi-Cal Rx effective January 1, 2022. See "Medi-Cal Rx begins January 1st, are you ready?". Note: use this link Office Hour Luncheon Session ,which is only available Monday-Friday, 12 p.m. to 1 p.m. PST (excluding holidays). Please note the prior authorization process and other essential information. Lastly, the Medi-Cal Rx customer service number is 1-800-977-2273 and is available 24 hours a day, 365 days a year after January 1, 2022. The Customer Service Center published a list of Main Menu Prompt Options.
Also in California, the Medi-Cal Rx Web Portal has been updated with the following. Note: Medi-Cal Rx will be implemented effective January 1, 2022.
- Countdown to Go-Live – Have You Reviewed the Medi-Cal Rx Pharmacy Transition Policy?
- Medi-Cal Rx Electronic Claims Agreement
Also in California, the Department of Health Care Services (DHCS) published its Stakeholder Communication Update – December 2021. Highlights include the following. See update for details and additional information.
- Continuous glucose monitors, as a pharmacy-billed medical supply benefit through Medi-Cal Rx, will be covered effective January 1, 2022. See Medi-Cal Rx: Transitioning Medi-Cal Pharmacy Services from Managed Care to Fee-for-Service Frequently Asked Questions (Version 10.0 – December 3, 2021).
- Medi-Cal Rx: For questions or comments related to Medi-Cal Rx, email RxCarveOut@dhcs.ca.gov
- CMS has approved SPA 21-0028, adding MTM as a payable Medi-Cal Fee-for-Service pharmacy service provided in conjunction with certain complex chronic medical conditions. participate in the program, Medi-Cal-enrolled pharmacies will be required to enter a contract with DHCS.
Also in California, the Department of Consumer Affairs issued a news release reminding providers of mandatory e-prescribing requirements effective January 1, 2022, pursuant to AB 2789 (Chapter 438, 2018).
Finally in California, the Department of Justice (DOJ) recently announced that Bamboo Health will be the new vendor for prescription data collection services for the Controlled Substance Utilization Review and Evaluation System (CURES). Additional details and information will be provided in the coming weeks regarding the transition process in early 2022 from the current vendor, Atlantic Associates Inc. (AAI), to the new vendor, Bamboo Health.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Georgia
The Georgia Medicaid Fee-For-Service pharmacy system has now been updated to accept a pharmacist’s NPI as the prescriber ID on flu vaccine claims using a Submission Clarification Code = 42. The below communication will be sent in an upcoming pharmacy banner.
PHARMACIST ORDERED FLU VACCINES
The U.S. Department of Health and Human Services (HHS) issued an eighth amendment to the Declaration under the Public Readiness and Emergency Preparedness Act (PREP Act), expanding the authority for pharmacists to order influenza vaccines. For flu vaccine claims with fill dates on or after 08/04/2021, pharmacies may utilize a Submission Clarification Code (SCC) of 42 in NCPDP Field: 420-DK in response to a rejection regarding prescriber NPI when the prescribing NPI is the pharmacist of record and is compliant with state and federal guidlines.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Board of Pharmacy published a Notice of Intended Action to amend the following. The deadline for comments is January 4, 202,2 at 4:30 p.m. Central.
Also, the Board adopted and filed Chapter 3 "Pharmacy Technicians" (ARC 6071C) which is currently in effect as an emergency rule.
Lastly, the Board published the following adopted and filed rules effective January 19, 2022:
- Chapter 3, "Pharmacy Technicians" (ARC 6071C)
- Chapter 8, "Universal Practice Standards" (ARC 6073C)
- Chapter 10, "Controlled Substances" (ARC 6074C)
- Chapter 3, "Pharmacy Technicians," Chapter 8, "Universal Practice Standards," Chapter 20, "Compounding Practices," and Chapter 39, "Expanded Practice Standards" (ARC 6076C)
- Chapter 21, "Electronic Data and Automated Systems in Pharmacy Practice" (ARC 6077C)
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
MedImpact has published a bulletin with override codes for early refills for patients impacted by tornadoes in Kentucky.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
The Department of Health (LDH) issued a revised Bulletin 19-3 outlining provider's options have to resolve issues with Medicaid Managed Care Organizations. (MCOs)
Also in Louisiana, despite objections from some lawmakers and the Attorney General, Gov. John Bel Edwards (D) announced that he is adding COVID-19 vaccinations to the list of required shots for students to attend schools and universities, effective for the 2022-23 school year.
Finally in Louisiana, NACDS submitted written comments to the Louisiana Board of Pharmacy in support of proposed rules that make permanent certain authorities for pharmacy technicians and interns authorized under the PREP Act. Specifically, the proposed rules would codify authority for pharmacy technicians and interns to administer vaccines, in addition to making other changes to the existing rules that simplify existing administrative requirements for vaccines provided by pharmacy providers. The Board will hold a public hearing on December 28, 2021.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Minnesota
The Minnesota Department of Health (MDH) will host a public, virtual meeting on Wednesday, December 29, 2021, at 2 p.m. CST to demonstrate the functionality of the registration system and provide an update on the technical build for the Prescription Drug Price Transparency Act (the "Act") (Minnesota Statutes 62J.84; amended by Minnesota Laws, 2021, Regular Session, Chapter 30 – HF 2128 – Article 3, Sec. 5 – 9). To join, use the Webex Meeting Link, Meeting Number (access code): 2494 346 4226, Meeting Password: tXaTGFdT722. MDH will post–meeting materials on the Prescription Drug Price Transparency Meetings page. Additional information is available online at www.health.state.mn.us/data/rxtransparency, where interested individuals and stakeholders may also subscribe to periodic updates.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
The RX Cares for Missouri Program, administered by the Missouri Board of Pharmacy, is seeking grant funding proposals for the purpose of developing or providing programs or education to promote medication safety or prevent prescription drug abuse, misuse, and diversion.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Department of Health and Human Services (DHHS) issued Provider Bulletin 21- 25 announcing December 2021 COVID-19 Vaccine Updates featuring updates on booster doses.
Also in Nebraska, the Department of Health and Human Services announced the next COVID-19 Medicaid Provider call will take place on January 5, 2022, at noon (Central).
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.